Healthcare Provider Details

I. General information

NPI: 1578685962
Provider Name (Legal Business Name): AMANDA NAVONE KUZIO MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA NAVONE GUARINO MFT

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 12/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 GLACIER DR.
MARTINEZ CA
94553
US

IV. Provider business mailing address

202 GLACIER DR.
MARTINEZ CA
94553
US

V. Phone/Fax

Practice location:
  • Phone: 925-313-4027
  • Fax: 925-957-2746
Mailing address:
  • Phone: 925-313-4027
  • Fax: 925-313-4110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number48659
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: